Home Posts tagged "Sturdy Shoulder Solutions" (Page 3)

Exercise of the Week: Bent-over T-Spine Rotation with Hip Hinge

I wanted to introduce you to a new exercise we've been playing around with lately. I created the bent-over thoracic spine rotation with hip hinge because I was looking for a way for athletes to avoid compensatory movements as we worked on thoracic spine mobility in the standing position. Essentially, you'll often see folks with limited thoracic spine mobility move East-West with the hips or laterally flex through the spine as they try to find motion in spite of their limitations. By pushing the butt back to the wall, we effectively block off compensatory hip motion (and work on a better hip hinge pattern at the same time).

Key coaching points:

1. By having the eyes follow the hand, you get some cervical rotation to help things along.

2. Make sure the upper back is moving and you aren't just "hanging out" on the front of the shoulder. This is especially true in a throwing population who may have acquired anterior shoulder laxity.

3. We'll usually do eight reps per side. This can be included as a single set during a warm-up, or for multiple sets as fillers during a training session (we'll often plug it in between medicine ball sets).

4. This is a better option for those who have active range-of-motion limitations to thoracic spine rotation, as opposed to passive limitations. In the case of the passive limitations, athletes are better off with things like side-lying windmills, where they have assistance from gravity (instead of having to compete against it).

To learn more about how we assess, program, and coach around the thoracic spine (and entire shoulder girdle), be sure to check out Sturdy Shoulder Solutions.

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3 Random Thoughts on Rotator Cuff Readiness

Both Cressey Sports Performance facilities are booming with baseball players coming back to start their offseason training, so it's the time of year when athletes are working hard to get their rotator cuff control back before they start up their offseason throwing programs. With that said, I've been thinking about some big principles on the rotator cuff readiness front.

1. In a broad sense, just about every rotator cuff exercise can be categorized in one of five ways:

a. Strength - this consists of manual resistance work and anything with cables at dumbbells; it needs to be loaded up and challenging.

b. Timing - this consists of drills like 90/90 holds and rhythmic stabilizations.

c. Endurance - this builds on what we see in Option A (some of the same exercises), but the resistance is a bit lower and it's done for higher reps or a longer time. The goal is less about strength and more about training the ability to hold the humeral head on the glenoid fossa for a lengthier period of time. I'd call it more important for a sport like swimming than for baseball or tennis athletes.

d. Irradiation - this can refer to just about any exercise, as your rotator cuff fires reflexively any time your arm moves. That said, certain exercises - bottoms-up kettlebell variations, for instance - are particularly useful for challenging this category of drills.

e. Patterning - these are just drills that take the humerus through its full range-of-motion. Of particular importance is end-range external rotation, which we train with drills like this:

2. I prefer near-daily exposures rather than exhaustive, less frequent programs.

If you look at our training programs, most of our pro guys are doing some kind of targeted training for the rotator cuff 5-6 days per week. Twice per week, we'll push more strength and irradiation work, and twice per week, we'll cover more timing drills. Just about every day, though, there will be some kind of patterning exercise so that we're reminding the cuff of what it's supposed to do.

This approach is a stark contrast to what you usually see in the baseball world, which is notorious for handing out the 2x/week arm care routines that take 45-60 minutes each. They're usually about 15 exercises for multiple sets, and leave an athlete hanging by the end of the session. I think this approach has more to do with the fact that it lines up with what's convenient for 2-3x/week physical therapy sessions than because it's truly optimal. I'm of the belief that you don't need (or want) to exhaust the cuff to get it to where it needs to be.

And, while we're at it, if the cuff is going to get abused on a daily basis with throwing, lifting, and activities of daily living, why not give it some more frequent exposure to build a little tissue resiliency?

3. Posterior deltoid shouldn't be lumped in with infraspinatus and teres minor.

Many times, the reason we have discomfort or the "wrong" feeling with drills is that athletes are paying close attention to the osteokinematics - gross movements of internal/external rotation, flexion/extension, adduction/abduction - of the joint in question, but not paying attention to the arthrokinematics of that same joint. In other words, the rolling, rocking, and gliding taking place needs to be controlled within a tight window to ensure ideal movement.

In shoulder external rotation variations, as we externally rotate the arm, the humeral head (ball) likes to glide forward on the glenoid fossa (socket). The glenohumeral ligaments (anterior shoulder capsule), rotator cuff, and biceps tendon are the only things that can hold it in the socket. In a throwing population, the capsule is usually a bit loose and the cuff is a bit weak, so the biceps tendon often has to pick up the slack - which is why some folks wind up feeling these in the front, thereby strengthening a bad pattern. There are also a bunch of nerves at the front of the shoulder that can get irritated.

Now, here's where things get a bit more complex. The infraspinatus and teres minor are both rotator cuff muscles that have attachments right on the humeral head, so they can control the arthrokinematics (posterior glide) during external rotation work. Conversely, the posterior deltoid (blue, in the image below) runs from the posterior aspect of the spine of the scapula to further down the arm on the deltoid tubercle. In other words, it completely bypasses control of the humeral head.


By Anatomography - en:Anatomography (setting page of this image), CC BY-SA 2.1 jp, https://commons.wikimedia.org/w/index.php?curid=22835985

With this in mind, the posterior deltoid actually creates a gliding forward of the humeral head as it externally rotates and horizontally abducts the arm. For this reason, you need to make sure the arm doesn't come back (horizontal abduction) as it externally rotates during your arm care drills. This video should clarify things, if you're a visual learner:

Looking for more insights like these? Be sure to check out my new resource, Sturdy Shoulder Solutions.

 

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Is It Really Biceps “Tendonitis?”

One of my biggest pet peeves is when all anterior shoulder pain is given a "blanket diagnosis" of biceps tendonitis. With that in mind, today, I've got a webinar excerpt from my Sturdy Shoulder Solutions resource (which is on sale for $40 off using coupon code APRIL22 right now) that delves into the topic in greater detail. Check it out:

For more information, check out www.SturdyShoulders.com. And, don't forget to enter coupon code APRIL22 to save $40 through Sunday at midnight!

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Case Study: Shutting Down Scapular Depression

I just posted this little "challenge" on Instagram. What do you see? 

I see some of the lowest shoulders in history. This is a well-muscled guy who looks like his upper traps are non-existent because he sits in such significant scapular depression. Take note of the angle of his clavicles; normally, they should have an upslode from the sternoclavicular joint to the acromioclavicular joint, but in this case, they're actually downsloped. Wherever the scapula goes, the collarbone follows. In this presentation, expect to see tissue density in lats, subclavius, and scalenes (among other areas).

The most interesting discussion point, though, is what to do about that upper trap tightness. That tightness is protective tension: his body doing anything it possibly can to avoid dropping any lower into scapular depression. The upper traps are working to elevate the scapula against gravity all the time. If you give him a bunch of massage and stretching, it's like picking a scab; he'll feel better for 15 minutes, and then in rougher shape over the long haul. You never want to stretch out protective tension.

He'd had previous bouts of unsuccessful physical therapy, and while I had the benefit of hindsight here, it was clear that the unifying theme of these approaches was an emphasis on the one-size-fits-all "pull the shoulder blades down" cue that gets thrown around all too much and usually leaves this presentation in a tough spot while helping a lot of senior citizen rotator cuff pain cases. You can't one-size-fits-all cues because everyone moves differently.

We modified his training to avoid anything with heavy weights tugging the shoulders down (no deadlifts, walking lunges, farmer's walks, etc.) and instead trained the lower body with lots of front squat and goblet set-ups, plus sled work, glute-ham raises, and barbell supine bridges/hip thrusts. We cut back on lat dominant upper body work and instead chose drills like push-up variations and landmine presses that drove scapular upward rotation (and even prioritized elevation, which is borderline heresy in some rehab circles). We got his arms overhead more often during the warm-ups and integrated some manual therapy in the areas I noted earlier. I even encouraged him to do less unsupported sitting at work, too, because his upper traps were competing against gravity all the time (yes, there are actually times that standing desks make things worse).

Today, two weeks to the day after the evaluation, he's feeling significantly better - and training hard. Posture is the interaction of structure and function, and if you can't identify aberrant postures, you're simply guessing with how someone is going to respond to a given exercise.

Interested in learning more about what I look for when evaluating the upper extremity - and how my findings drive our programming and coaching cues? Check out Sturdy Shoulder Solutions (which is on sale for $50 off through Sunday at midnight) at www.SturdyShoulders.com.

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Building Mobility Efficiently: Modified Pigeon with 1-arm Child’s Pose

Here's another Sturdy Shoulder Solutions sale inspired post. The Modified Pigeon with 1-arm Child's Pose is another new drill we've busted out in our warm-ups to get a little more bang for our buck. It's particularly useful for pitchers, who need to get into their lead hip (adduction) while getting lat length, scapular upward rotation, and apical expansion on the throwing shoulder.

A few big coaching points:

1. You should feel a stretch in the outside of the front hip, but nothing in the knee (particularly the inner part). If you're feeling it in your knee, you've probably set up incorrectly.

2. Think of a stretch along the entire outside of the torso and arm: quadratus lumborum, lats, and long head of triceps, especially. If you pinch at the front/top of the shoulder, ease off it a bit.

3. Breath in through the nose and exhale fully through the mouth as if you're blowing out birthday candles (and hold for a count of three before inhaling again). You should feel your abs turn on as the shoulder stretch increases. Do five breaths.

You can learn more about how I assess, program, and coach at the shoulder girdle - and save $50 through Sunday at midnight - at www.SturdyShoulders.com.

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Video: When Should You Train Shoulder Internal Rotation?

With this week's $50 off sale on Sturdy Shoulder Solutions, (using coupon code podcast5), let's cover a question I got a while back. A reader asked whether it was ever useful to train shoulder internal rotation. With the lats and pecs (both internal rotators) always getting blasted in a typical strength training program, is any specific work for internal rotation ever recommended? My response warranted a three-part video, which I've compiled into one here:

To learn more about how I assess, program, and coach at the shoulder girdle, check out Sturdy Shoulder Solutions. It's on sale for $50 off through Sunday at midnight. Just use coupon code podcast50 at checkout.

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Exercise of the Week: Wall Slides with Upward Rotation and Lift-off to Swimmer Hover

With this week’s $50 off sale on Sturdy Shoulder Solutions, I wanted to introduce a new drill I’ve started using. The wall slide with upward rotation and lift-off to swimmers hover effectively blends two schools of thought: Shirley Sahrmann’s work and that of Functional Range Conditioning.

1. With the wall slide portion, we drive scapular upward rotation.

2. With the lift off portion, we get scapular posterior tilt and thoracic extension (as opposed to excessive arm-only motion).

3. With the swimmer hover, we lengthen the long head of the triceps and even drive a little bit more serratus anterior recruitment as the scapula rotated around the rib cage.

Get exposure to multiple philosophies and have an appreciation for functional anatomy, and the exercise selection possibilities are endless. Learn more at www.SturdyShoulders.com.

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Off-season Shoulder Sale!

Our professional baseball guys are rolling back in to kick off the offseason, so I wanted to offer a sale to celebrate this fun time of year. What better way to celebrate the unofficial start of the baseball offseason than to put my shoulder course, Sturdy Shoulder Solutions, on sale for $50 off through Sunday?

This product includes over six hours of cutting edge assessment, coaching, and programming strategies. You can learn more at the following link (with the discount automatically applied):

http://www.SturdyShoulders.com


Here's what you'll experience:

  • Simplifying Shoulder Health (Webinar)
  • How Posture Impacts Pain and Performance (Webinar)
  • Important Upper Extremity Functional Anatomy Considerations (Webinar)
  • The Proximal-to-Distal Principle (Webinar)
  • Nuances of the Neck (Webinar)
  • Rethinking the Thoracic Spine (Webinar)
  • Making Sense of Serratus Anterior (Webinar)
  • Is Upper Trapezius the Devil? (Lab)
  • The Myth of Normal Range of Motion (Lab)
  • Rethinking the Thoracic Spine (Lab)
  • Making Sense of Serratus Anterior (Lab)
  • Good Exercises Gone Bad (Lab)
  • The Myth of Balancing Pushes and Pulls (Lab)

It's a great fit for personal trainers, strength and conditioning coaches, sports coaches, and rehabilitation specialists. Additionally, many fitness enthusiasts will appreciate the focus on individualizing programming recommendations and technique coaching strategies.

In particular, it’s a tremendous fit for anyone who has previously been exposed to our Optimal Shoulder Performance and Functional Stability Training products. Sturdy Shoulder Solutions serves as an up-to-date companion to the educational material covered in those previous offerings.

You'll get instant online access to this digital-only product after purchase. Just head to http://www.SturdyShoulders.com to pick it up.

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Random Thoughts on Long-Term Fitness Industry Success – Installment 11

It's time for a new edition of my thoughts on the business of fitness. Before I get to it, just a friendly reminder that we're hosting our second-ever Cressey Sports Performance Business Building Mentorship on October 15. You can learn more HERE.

Now on to some business concepts...

1. It might take years for someone to become a customer.

Just a few weeks ago, I released my newest product, Sturdy Shoulder Solutions. One interesting thing about my newsletter/product management set-up is that I can tell how long someone has been a "prospect" before becoming a customer. Basically, I know the date they signed up for my newsletter, and then I can check that out to see what products they've purchased and when.

During this launch, I had multiple people purchase this resource as their first purchase with me after over 3,000 days on my list. Yes, that means they "window shopped" for over eight years prior to taking the plunge.

Very few people purchase on the first exposure to a marketing message. Or the second. Or the third. It actually takes load of opportunities for them to perceive your expertise, and usually over the course of an extended period of time. They need to know, like, and trust you - and some people take a long time to get to trusting you enough to initiate a transaction.

Be persistent, but patient. It's harder than ever to be seen and heard.

2. It's a very small world; watch your social media behavior.

I made this post on Twitter yesterday, and it got quite a bit of attention.

 Beyond the obvious moral issues of saying cruel things to pro athletes (or celebrities - or anyone else, for that matter), you should be cognizant of the fact that it can very quickly come back to bite you in the butt. Some of the agencies who represent these players may also represent others - athletes, actors, musicians, speakers, or coaches - who could be potential future clients for you. One of your followers could be an old friend or teammate of the athlete. It's an incredibly small world, so chasing a few retweets isn't worth sacrificing a relationship or potential client down the road.

3. Investments are different from expenses.

This is one of the most misunderstood accounting/economics concepts in all industries, and certainly in the fitness business.

An investment has the potential to appreciate in value. Maybe you spend money on a continuing education event, buy a DVD for some new training strategies, put money into a retirement account, or purchase some equipment that allows you to deliver a higher-quality product to your clients. Perhaps you hire a consultant to fine-tune your business, or decide to buy your building instead of continuing to pay rent. Additionally, from an accounting standpoint, investments are usually (but not always) tax deductible.

Expenses are like setting money on fire. They're the $5 you spend at Starbucks each morning, or the Porsche you bought on credit when you were making $20,000/year (is that even possible?). They don't appreciate, and there is a huge opportunity cost to these expenditures. Some are necessary and even tax deductible (e.g., rent), but they always need to be heavily scrutinized. Can that expense be reduced or somehow shifted into an investment?

Fitness businesses are notoriously bad at understanding the difference between the two, or understanding that one's financial situation may dictate what is and isn't acceptable. If you're grossing $5,000/month, paying $1,000/month to a cleaning service probably isn't a good expense; clean the gym yourself. Do you really need to buy seven different types of leg curl machines when you're already $300,000 in debt? And, why do you have payroll expenses when you've only got three clients?

Most businesses (and individuals, in their personal finances) would be wise to go through every cash expenditure and figure out how each one can be categorized. Growing gross revenue is always a priority, but many businesses can be even more profitable if they learn to appropriately trim the fat.

If you've found value in these insights, I think you might enjoy the upcoming Business Building Mentorship Pete Dupuis and I will be hosting on Monday, October 15th. It's a tax deductible expense if you're a fitness business owner, and we'd guarantee that the lessons learned will more than pay for the cost of attendance. Plus, registration in the mentorship includes free attendance at our fall seminar on October 14.

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Why Rhomboids Probably Aren’t Your Best Friend

Today, I've got an excerpt from my new course, Sturdy Shoulder Solutions. I discuss the functional anatomy of the rhomboids, a commonly misunderstood muscle group with big implications.

For a lot more functional anatomy insights like these - as well as a comprehensive look at shoulder assessment, programming, and coaching - be sure to check out Sturdy Shoulder Solutions.

Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!

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